Olivia Stallard, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401416861 Issued in VA

Practice address

5626 Patriot Dr
Wise, VA 24293-1138

Phone

(276) 328-8850

NPI assigned

Jun 4, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr Olivia Stallards Downtown Dental PLLC

  • Dentist
  • Norton, VA
  • NPI 1689420127
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1972127074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 118",
            "city": "COEBURN",
            "state": "VA",
            "postal_code": "242300118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5626 PATRIOT DR",
            "city": "WISE",
            "state": "VA",
            "postal_code": "242931138",
            "telephone_number": "276-328-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLARD",
        "first_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401416861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Short, FNP
• Dana Sibrel, MA, ATC
• St. Mary'S Health Wagon
• St. Mary'S Health Wagon
• St. Mary'S Pharmacy
• Autumn Marie Starnes, D.O.
• Chritsopher T. Starnes, M.D.
• Stephanie Strouth, LPC
• Erra Jo Sutherland, WHNP
• David E Templeton, DDS

• All providers in Wise, VA
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.